Re: Death rates in people with BMIs over 30?

[Guest guest]

>

> Death rates in people with

> BMIs over 30?

> > To: Supertraining

> > Date: Friday, December 19, 2008, 2:37 PM

> > What are the statistics on death rates in

> > people with BMIs over 30 who are physically active?

> > Conventional wisdom is they are lower than in inactive

> > people� but maybe not.

>

> > I am a 61 year old masters discus thrower and have

> competed

> > and lifted weights since 1963 (with only a few short

> > breaks). My BMI is 31, but I am in good shape. During

> the

> > past few years, eight friends died at relatively

> young

> > ages (55-66 yr), all of whom were world class

> strength

> > athletes and physically active. While eight

> observations

> > don't mean much, it makes me nervous.

> >

 longevity and health in old strength

> athletes.

> >

> > Tom Fahey

> > California State Univ, Chico

Tom I have been thinking about your your statement:

*************

" During the past few years, eight friends died at relatively young ages (55-66

yr), all of whom were world class strength athletes and physically active.

While eight observations don't mean much, it makes me nervous. "

*************

Eight men (55-66) in apparent good health dying unexpectedly, in my opinion, is

not insignificant unless maybe you have 1000 friends in that age group. I would

think that even 8/100 would be a significant number given that the expected life

expectancy of an average male is in the mid 70s.

With your back ground and experience it should not be difficult to gather a

cohort of men in that age to see what the expected untimely death rate would be.

Since they are friends, perhaps the families might be willing to give you access

to their medical records and possibly autopsy reports ( I don't know what the

present protocol is but in the past untimely deaths called for autopsies).

It may sound gruesome to some readers but not all autopsies are done for

forensic reasons. They are frequently done at hospitals to determine the cause

of death when there is no obvious reason. The findings are often helpful to

family members particularly if possible hereditary causes can be found.

With that information,Tom, you would be in a position to generate an important

study. If you know eight men who died prematurely it might not take long

through questionnaires given to your friends to come up with a larger sample.

Perhaps athletes should have echocardiograms done routinely over a certain age

as well as holter monitors to determine if there is an propensity to cardiac

arrhythmia.

Ralph Giarnella MD

Southington Ct USA

[Guest guest]

Tom wrote:

****In general, the strongest athletes had asymmetrical

hypertrophy, with large interventricular septum diameters and

normal posterior wall thickness.****

Tom, as I understand it, and as I'm sure you know,

endurance-trained athletes with hypertrophy have a balance

between septum diameter and posterior wall, ie, both expanded, --

as summed up nicely in this paper:

" The thickness of both the septum and posterior wall increases to

the same extent as the interior volume. The mass/volume ratio,

and therefore the maximum systolic wall stress, remains constant

in contrast to pathologic forms of hypertrophy. "

Herz. 2004 Jun;29(4):373-80. [Endurance training and cardial

adaptation (athlete's heart)]

However, the following paper says that concentric hypertrophy

cannot be caused by strength training alone, eg:

" To differentiate between physiological and pathological

myocardial changes, the relationship between heart size and

ergometric performance as well as the echocardiographically

measured ratio between left ventricular (LV) myocardial thickness

and volume are useful; the latter remains unchanged, on the

whole, in endurance- and strength-trained athletes. Concentric

hypertrophy cannot be induced by strength training alone;

additional factors, such as hypertension, aortic stenosis,

cardiomyopathy or anabolic steroid use can play an important

role. "

Sports Med. 1992 Apr;13(4):270-84. Echocardiographic findings in

strength- and endurance-trained athletes. Urhausen A, Kindermann

W.

(It seems to me that the chronic and delayed hazards of anabolic

steroids were very much underestimated in the early days.)

From what I can tell from a brief review, strength training,

bodybuilding, power training etc, do not intrinsically confer any

pathological structural effects on the heart in the absence of

other risk factors. See a wide-ranging meta review (full text)

here:

Circulation. 2000 Jan 25;101(3):336-44. The athlete's heart. A

meta-analysis of cardiac structure and function. Pluim BM,

Zwinderman AH, van der Laarse A, van der Wall EE.

http://tinyurl.com/7cev6q

The issue of arterial compliance - artery stiffness or elasticity

- in strength-trained men and women is still being debated, and

although it seems that strength training increases arterial

stiffness compared to aerobic training, the health impacts of

this do not seem to be clear, if they exist at all. It's worth

watching though.

1. Bertovic DA, Waddell TK, Gatzka CD, et al. Muscular strength

training is associated with low arterial compliance and high

pulse pressure. Hypertension. 1999 Jun;33(6):1385-91.

2. Kawano H, Tanimoto M, Yamamoto K, et al. Resistance training

in men is associated with increased arterial stiffness and blood

pressure but does not adversely affect endothelial function as

measured by arterial reactivity to the cold pressor test. Exp

Physiol. 2008 Feb;93(2):296-302.

Regarding collateral blood supply, steady-state, continuous

aerobic training seems to build much more collateral capacity

than exercise of shorter duration, even interval training. In

this study below, interval training built a much higher VO2, but

aerobic training produced twice as much capillary density.

Effect of interval versus continuous training on

cardiorespiratory and mitochondrial functions: relationship to

aerobic performance improvements in sedentary subjects. Daussin

FN, Zoll J, Dufour SP, et al. Am J Physiol Regul Integr Comp

Physiol. 2008 Jul;295(1):R264-72. 2008

It seems to me that this all points to a need for strength

training athletes to include some steady-state aerobic training

in their programs, even if it's only regular walking. Mel Siff

was skeptical about aerobic training, but the evidence suggests

this is one thing he got wrong.

Of course, none of this may have anything to do with the observed

mortality of strength-trained athlete's that Tom describes. Other

risk factors such as diet, waist circumference and cholesterol

status could account for much of the excess risk.

Gympie, Australia

[Guest guest]

I disagree that Mel was wrong - and I am plenty fit without doing any formal

cardio (I gave that up a few years ago completely...). I've also seen a couple

of my friends injured doing cardio - not those ever so alleged dangerous

weights!

The Phantom

aka Schaefer, CMT, competing powerlifter

Denver, Colorado, USA

===========================

-------------- Original message --------------

Tom wrote:

****In general, the strongest athletes had asymmetrical

hypertrophy, with large interventricular septum diameters and

normal posterior wall thickness.****

Tom, as I understand it, and as I'm sure you know,

endurance-trained athletes with hypertrophy have a balance

between septum diameter and posterior wall, ie, both expanded, --

as summed up nicely in this paper:

" The thickness of both the septum and posterior wall increases to

the same extent as the interior volume. The mass/volume ratio,

and therefore the maximum systolic wall stress, remains constant

in contrast to pathologic forms of hypertrophy. "

Herz. 2004 Jun;29(4):373-80. [Endurance training and cardial

adaptation (athlete's heart)]

However, the following paper says that concentric hypertrophy

cannot be caused by strength training alone, eg:

" To differentiate between physiological and pathological

myocardial changes, the relationship between heart size and

ergometric performance as well as the echocardiographically

measured ratio between left ventricular (LV) myocardial thickness

and volume are useful; the latter remains unchanged, on the

whole, in endurance- and strength-trained athletes. Concentric

hypertrophy cannot be induced by strength training alone;

additional factors, such as hypertension, aortic stenosis,

cardiomyopathy or anabolic steroid use can play an important

role. "

Sports Med. 1992 Apr;13(4):270-84. Echocardiographic findings in

strength- and endurance-trained athletes. Urhausen A, Kindermann

W.

(It seems to me that the chronic and delayed hazards of anabolic

steroids were very much underestimated in the early days.)

From what I can tell from a brief review, strength training,

bodybuilding, power training etc, do not intrinsically confer any

pathological structural effects on the heart in the absence of

other risk factors. See a wide-ranging meta review (full text)

here:

Circulation. 2000 Jan 25;101(3):336-44. The athlete's heart. A

meta-analysis of cardiac structure and function. Pluim BM,

Zwinderman AH, van der Laarse A, van der Wall EE.

http://tinyurl.com/7cev6q

The issue of arterial compliance - artery stiffness or elasticity

- in strength-trained men and women is still being debated, and

although it seems that strength training increases arterial

stiffness compared to aerobic training, the health impacts of

this do not seem to be clear, if they exist at all. It's worth

watching though.

1. Bertovic DA, Waddell TK, Gatzka CD, et al. Muscular strength

training is associated with low arterial compliance and high

pulse pressure. Hypertension. 1999 Jun;33(6):1385-91.

2. Kawano H, Tanimoto M, Yamamoto K, et al. Resistance training

in men is associated with increased arterial stiffness and blood

pressure but does not adversely affect endothelial function as

measured by arterial reactivity to the cold pressor test. Exp

Physiol. 2008 Feb;93(2):296-302.

Regarding collateral blood supply, steady-state, continuous

aerobic training seems to build much more collateral capacity

than exercise of shorter duration, even interval training. In

this study below, interval training built a much higher VO2, but

aerobic training produced twice as much capillary density.

Effect of interval versus continuous training on

cardiorespiratory and mitochondrial functions: relationship to

aerobic performance improvements in sedentary subjects. Daussin

FN, Zoll J, Dufour SP, et al. Am J Physiol Regul Integr Comp

Physiol. 2008 Jul;295(1):R264-72. 2008

It seems to me that this all points to a need for strength

training athletes to include some steady-state aerobic training

in their programs, even if it's only regular walking. Mel Siff

was skeptical about aerobic training, but the evidence suggests

this is one thing he got wrong.

Of course, none of this may have anything to do with the observed

mortality of strength-trained athlete's that Tom describes. Other

risk factors such as diet, waist circumference and cholesterol

status could account for much of the excess risk.

=======================